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| And what about the economy of nursing home care? | |
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| Tweet Topic Started: Jul 15 2010, 04:34 AM (580 Views) | |
| kathyk | Jul 15 2010, 04:34 AM Post #1 |
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Pisa-Carp
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Here's another topic related to the cost/benefit of health care. I work with elderly folks and their families. I have yet to meet a person (well, maybe there was one) who looks foward to the day they can kick up their heels in a nursing home. Most people dread that possibiity. I can't tell you how many times I've heard people say they would rather die than be put in a nursing home - the standard line is, "take me out and shoot me." I was really upset the other day to learn of the death of a client of mine. It wasn't the fact of his death that bother me. He was in his late 90s. I last saw him around five years ago. After his wife died, he moved from their apartment into a very nicely equipped independent living center. He adjusted well to the new setting and continued to live contentedly. Although he had no children, he seemed to really enjoy his quiet life. As a single, tall, nice lookoing gentleman, he was quite popular there getting more attention from widows than he wanted or needed. Anyway, when his nephew came to see me the other day, I asked about his death and how things went for him. I was shocked and dismayed to learn that he had spent his last five years in a nursing home. The nephew told me how he had suffered a stroke and suddenly (as so often is the case) became totally debilitated. He indicated over and over that all he wanted was to die and begged to not be put in a nursing home. Well, what are are the alternatives? So, he not only ended up in a nursing home, but languished there, in a near catatonic state for five years. Aside from the horror of being warehoused in a near-death state for such a long period of time, the economic waste is staggering. He blew through nearly half million dollars in the period paying for care the kept him breathing but in misery. There is something so very wrong with about this. These languishing nursing home stays are impoverishing families and keeping people alive who would much rather die. But, what are the alternatives? I know what i would want in the situation. A pill I could pop that would put me into a permanent sleep. Washington has assisted suicide. I'm not sure it would even apply in a like this, as I believe there has to be a terminal illness with some quantifiable estimate at the number of months expected to live. Edited by kathyk, Jul 15 2010, 04:39 AM.
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| Blogging in Palestine: http://kksjournal.com/ | |
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| apple | Jul 15 2010, 05:11 AM Post #2 |
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one of the angels
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that was my mother's greatest fear, and thankfully she passed quickly after 30 hours in the hospital. I don't want my body to languish. i would suggest a rider to the living will... or something like that. the cost is not an issue for me. |
| it behooves me to behold | |
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| Copper | Jul 15 2010, 05:47 AM Post #3 |
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Shortstop
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Pardon me, but you guys are nuts. I want to fight for every minute, dignity be damned, no question. |
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The Confederate soldier was peculiar in that he was ever ready to fight, but never ready to submit to the routine duty and discipline of the camp or the march. The soldiers were determined to be soldiers after their own notions, and do their duty, for the love of it, as they thought best. Carlton McCarthy | |
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| Jolly | Jul 15 2010, 05:56 AM Post #4 |
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Geaux Tigers!
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It's a false conundrum. The nursing home does not have to feed you, if you have legally refused. You'll be dead in just a few days. Problem solved. |
| The main obstacle to a stable and just world order is the United States.- George Soros | |
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| Axtremus | Jul 15 2010, 06:10 AM Post #5 |
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HOLY CARP!!!
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Refusing feeding is a lot more uncomfortable and inefficient than popping a pill. Just let people pop pills if they want to. Simple as that. |
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| Jolly | Jul 15 2010, 06:14 AM Post #6 |
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Geaux Tigers!
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If you want to pop pills, be my guest. Or eat a .45 one fine, sunny morning. Nobody can stop you. It may be illegal, but hey... Hard to prosecute a corpse. |
| The main obstacle to a stable and just world order is the United States.- George Soros | |
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| Axtremus | Jul 15 2010, 06:21 AM Post #7 |
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HOLY CARP!!!
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Legalise licensed professionals to help with the delivery of the pills. That allows the incapacitated and the infirm to enjoy the same benefits, and is the humane thing to do. |
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| Jolly | Jul 15 2010, 06:24 AM Post #8 |
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Geaux Tigers!
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No. No medical professional should be told by the government that they are responsible for terminating life. If you want to take your own, I've already shown there is nothing standing in your way. Get your house in order before you get to that point and you won't have a problem...specify pallitive care only and nature will take its course. |
| The main obstacle to a stable and just world order is the United States.- George Soros | |
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| Dewey | Jul 15 2010, 06:29 AM Post #9 |
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HOLY CARP!!!
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Yes. One further note: the argument of how much money is being spent on such care is a unnecessary as it is ethically appalling. If someone has specified (either directly or by omission) that they want to continue on as long as possible, that wish should be complied with, cost be damned. Applying that argument then makes such an argument all too applicable to the severely mentally or physically disabled, or simply severely old. There's no need to go there. Period. |
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"By nature, i prefer brevity." - John Calvin, Institutes of the Christian Religion, p. 685. "Never waste your time trying to explain yourself to people who are committed to misunderstanding you." - Anonymous "Oh sure, every once in a while a turd floated by, but other than that it was just fine." - Joe A., 2011 I'll answer your other comments later, but my primary priority for the rest of the evening is to get drunk." - Klaus, 12/31/14 | |
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| kathyk | Jul 15 2010, 06:59 AM Post #10 |
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Pisa-Carp
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But, they do. They will continue to spoon feed people even as they are grimacing and spittting out the food. This happens all the time. You can't blame the nursing homes. To not feed them would be perceived as inhumane, and then there's the ever present spectre of legal liability. In many cases, as I imagine happened with this client, his capacity had become greatly compromised, and he probably lost the will to resist.. He knew very clearly what he wanted, but with his diminished capacity, all he could do is curl up in a ball and fade away - it's just that it took him five years to do so. |
| Blogging in Palestine: http://kksjournal.com/ | |
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| kathyk | Jul 15 2010, 07:01 AM Post #11 |
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Pisa-Carp
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Again, with progressive diseases like Alzheimer's and Parkinson's, by the time the person is at the point where they would have wanted to terminate their life, they no longer have the capacity to do so. |
| Blogging in Palestine: http://kksjournal.com/ | |
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| kathyk | Jul 15 2010, 07:04 AM Post #12 |
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Pisa-Carp
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But, that is often first and foremost on the person's mind who is planning for his long term care. The lion's share of my clients come to me because they are terrified of the prospect of blowing through an entire life's savings paying for their own nursing home care. Add to that the fact that most of my clients express the desire that they do not want to live out the end of their life in a nursing home. |
| Blogging in Palestine: http://kksjournal.com/ | |
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| Horace | Jul 15 2010, 07:57 AM Post #13 |
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HOLY CARP!!!
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God bless ya, pay for it yourself then. If I could opt out of the tax/insurance burden to pay for people who want infinite end of life care, and in exchange forgo it myself, I'd do it. |
| As a good person, I implore you to do as I, a good person, do. Be good. Do NOT be bad. If you see bad, end bad. End it in yourself, and end it in others. By any means necessary, the good must conquer the bad. Good people know this. Do you know this? Are you good? | |
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| KlavierBauer | Jul 15 2010, 08:09 AM Post #14 |
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HOLY CARP!!!
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I understand the desire to end life when things get miserable. Twice in my life I've been right at the brink, and have had to consciously choose whether to go on or not, it's a tough decision when in the midst of anguish and misery. For me though - it becomes a spiritual issue (and therefore probably not worth discussing with folks doing a cost/benefit analysis). I agree with Jolly on this one - it isn't the State's business to be in the game of terminating people's lives. It's a very slippery slope, and there are already many provisions for people in a "near death" state (the above example in this thread wouldn't be "near death" in my book). |
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"I realize you want him to touch you all over and give you babies, but his handling of the PR side really did screw the pooch." - Ivory Thumper "He said sleepily: "Don't worry mom, my dick is like hot logs in the morning." - Apple | |
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| Jolly | Jul 15 2010, 08:20 AM Post #15 |
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Geaux Tigers!
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My father did not have a problem. He made his wishes known, everything was tied up in a nice legal knot and when he reached the point where he needed nursing home care, he soldiered on as long as possible. But when it came time for a feeding tube or die, I told the DON his preferences were on file and to make him as comfortable as possible until his death. |
| The main obstacle to a stable and just world order is the United States.- George Soros | |
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| Friday | Jul 15 2010, 10:13 AM Post #16 |
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Senior Carp
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Kathy You ask about alternatives. Here's one: How about the family/next of kin/DPOA/ or whatever stand up for your elderly gentleman and follow his wishes? My father suffered a strike and refused rehab. It was hard on my mother, but she followed his desire to be brought home. He was with us for two weeks before he passed, and it was wonderful. Your elderly gentleman didn't have children, but he had a nephew. I don't see this as a nursing home issue or a legislative issue at all. |
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| ivorythumper | Jul 15 2010, 10:44 AM Post #17 |
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I am so adjective that I verb nouns!
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Maybe nursing home care should be considered as a voluntary form of wealth redistribution... it feeds all those who work in the industry and the stock holders. Good for the economy since otherwise that money will largely go to death taxes anyway. |
| The dogma lives loudly within me. | |
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| Dewey | Jul 15 2010, 10:56 AM Post #18 |
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HOLY CARP!!!
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You've missed my point. If those people are coming to you, expressing the intent that they don't want to blow a half a million dollars in prolonging life in that circumstance, *they* have the right to express so, and to do it legally and in advance - that's what they're talking to *you* about. They're doing what they should. My argument that the economic issue cannot be used is relative to a person who has *not* made clear in advance that this would be their desire, or who has expressly stated that they want to hang on as long as they can. Of course, the economic issue is a legitimate issue for the individual, in advance. |
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"By nature, i prefer brevity." - John Calvin, Institutes of the Christian Religion, p. 685. "Never waste your time trying to explain yourself to people who are committed to misunderstanding you." - Anonymous "Oh sure, every once in a while a turd floated by, but other than that it was just fine." - Joe A., 2011 I'll answer your other comments later, but my primary priority for the rest of the evening is to get drunk." - Klaus, 12/31/14 | |
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| Copper | Jul 15 2010, 12:01 PM Post #19 |
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Shortstop
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I look forward to paying for it myself. I don't want even one penny from the government. And this is one of the main reasons I don't. Having my death be in the government's best interest can never be a good thing. And yes the people who think the government owes everyone infinite health care are loony. |
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The Confederate soldier was peculiar in that he was ever ready to fight, but never ready to submit to the routine duty and discipline of the camp or the march. The soldiers were determined to be soldiers after their own notions, and do their duty, for the love of it, as they thought best. Carlton McCarthy | |
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| ivorythumper | Jul 15 2010, 01:15 PM Post #20 |
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I am so adjective that I verb nouns!
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it is for the rest of us.
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| The dogma lives loudly within me. | |
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| Mikhailoh | Jul 15 2010, 01:27 PM Post #21 |
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If you want trouble, find yourself a redhead
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Ouch, IT! That's gonna leave a welt.
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Once in his life, every man is entitled to fall madly in love with a gorgeous redhead - Lucille Ball | |
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| apple | Jul 15 2010, 01:42 PM Post #22 |
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one of the angels
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heh |
| it behooves me to behold | |
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| Copper | Jul 15 2010, 02:39 PM Post #23 |
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Shortstop
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The Confederate soldier was peculiar in that he was ever ready to fight, but never ready to submit to the routine duty and discipline of the camp or the march. The soldiers were determined to be soldiers after their own notions, and do their duty, for the love of it, as they thought best. Carlton McCarthy | |
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| kathyk | Jul 15 2010, 03:10 PM Post #24 |
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Pisa-Carp
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That's true if it comes down to a feeding tube, or artificial hydration or other invasive means of prolonging a life. What I'm talking about are the less invasive measures like spoon feeding a person even though they're grimacing and spitting out half of the food. That happens *all the time* in nursing homes. Most of those people are too out of it to express their wishes anymore, and even if they have good written advance health care directives, they don't allow a caregiver to stop feeding the person when they can still swallow food. |
| Blogging in Palestine: http://kksjournal.com/ | |
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| kathyk | Jul 15 2010, 03:14 PM Post #25 |
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Pisa-Carp
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That is certainly the best scenario, although it can be extremely hard on the care giving spouse if the debilitated spouse hangs on for a long time. It would be great if everyone could have a situation like your father did. Death is a natural process, but with advances in medicine, in so many cases it has become completely unnatural and institutionalized. |
| Blogging in Palestine: http://kksjournal.com/ | |
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12:41 AM Jul 11